HomeMy WebLinkAboutPermit Building 1999-4-6
RESIDENTIAL
PERMIT APPLICATION
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Inspectl~s: 726.3769)
Office: 120'''/0':1
LOCATION OF PROPOSED WORK: <t f fv.
ASSESSORS MAP' 171}':). J Y3
LOl'
OWNER'
7~ft1
CITY'
DESCRIBE WORK:
NEW
REMODEL
CONTRACTOR'S NAME
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GNST
GENERAl'
PLUMBING'
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BLOCK'
WMJ
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JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
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TAX LOT' OS! tIJ()
STAT~'
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ADDITION
DEMOLISH
OTHER
SUBDIVISION:
PHONF'
7'1'1- n I?---
ZIP:
17-'(77
ADDRESS
71?'f'f
CONST.
CONTflACTOR .
12lft/ol
PHONE
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RANGF'
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to
CQver.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
@ramlng - Prior to cover,
o Wall/C"elllng Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert - After fireplace approve!
and Installation of unit,
o Curbellt & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is compioto, forms
and sub.base material In place.
o Fence - When completed.
o Street Trees - When all required
trees Bre planted.
EXPIRES c>
79'Y-.
MECHANICA' .
ELECTRICAL: ---'01' .,")____n 10,,, rAouires you to
'. AI it=hlil 1;j.~'_-:~..JLo...+hOnrAnonUtilitY
NT~~~~c';,;i~~C;~t~r'.-Tho'se rules are set fO@ OFFICE US~:-
o I I 0010 through OAR 952-001- ~Ild TICE:
QUAD AREA-::lAR 952-001- 'f tlhAl;olDEI!ISJ;: FkO.OD J?LAI~'
0090. You may OOHi" , wt'les 0 1'-....hQ e I ~:Jti t"t:HMII tiHALL EXI"IHE It' I Ht: V":Jl1i\
· OF BLDGS',nlt\- - 'r- Mn"" (Note: the tell30F l1NITS: ZO/)(ING CODE:
CU ". ,9 i-the Oregon Utility Notification I' "UHILt:U LINDER I HI:; t"t:RIVIf I I::> NU I
OCCY GROUlp",ber or -.,..-32.234-c::PNSTR. TYPE: - - -- OR IS ,~,9F.DBORM'" --
Center IS \ -oVU.~ I:.I"v'"=U ,hur\l~ UI'lI:U rvn
· OF STORIES: HEAT SOURCE: _, ..'" M -, JERIOD SECONOARY HEAT:
1"\1'11 IUVLlnl f .
SQUARE FOOTAGE:
To request an Inspection, you must call 726,3769, This Is a 24 hour recording. All Inspections requested before 7:00 a.m. will be
made the same working day. Inspections requested after 7:00 a.m. will be made the following work day.
o Final Plumbing - When all
plumbing wc;>rk Is complet.e.
D Final Electrical - When all
electrical work Is complete.
o Final Mechanlcal- When all
mechanical work Is complete.
~F al Building - When all
qui red Inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When al/
blocking Is complete.
o PlumbIng Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set.up, and plumbing
Inspections have been approved
and the home Is connected to
the servIce panel.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
,-
WATER HEATER'
o Temporary Electric
O Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslsb Plumblng/Electrlcall
~hanlcal - Prior to cover.
aotlng - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to IIIl1ng
trench.
D Storm Sewer - Prior to filling
trench.
O Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
Lot faces
lot ~ype .
Interior
lot sq. ftg.
Lot coverage
Corner
Topography
Total height
.
Panhandle
Cul-de-sac
BUILDING PERlliJlT
ITEM SO. FT.
'~
X $/SO. FT. =
Main
Garage
Carport
#klb6 tull~
Total Value
Building Permit Fee
State Surcharge
Total Fec
(A)
I P.L.
IN
Is
w
----
E
VALUE
"
l{ 'j '}-O
l.f}.lO
r/J,~<5
;;(/t;')
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
<)tJC-
Total Miscellaneous .Permlts (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
b r. 6.)
OS.V
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1i1"'i,;j:\;'
'i.'THEPROPOSED WORK IN THE.
'''HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setbacks
'HSE'GAR'ACcl
I
I
I
J
APPROVED'
, '.\. '., ".
BUILDING VALtJE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by the City ,of Springfield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee: -;;732- :i 3
Date Paid: ~~7
Receipt Number' /j '1 J J t ? ,
Received af {J~' tJ~
Plans Reviewed By
~/rJ
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
By signature, I stato and agree, that I have carefully examined
the completed application and do hereby certify that all
Information horeon Is true and correct, and I further certify
that any and all work performed shall be done In accordance
with the Ordinanc~s of the City of Springfield, and the Laws
of the State of Oregon pertaining to tho work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certify that only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
I further agree to ensure that all required Inspections are
requested at the proper time. that each address Is readable
from the street, that the permit card Is located at the front
of the proper~and the approved set of plans will remain
on the site at I ti s dur g construction.
Slgnaturp j(
'I ;; iu
I I
Date
VALIDATION:
t?31'107
RECEIPT NUMBER I
DATE PAID 'if' f~ f
AMOUNT RECEIVED "2..3 2-f>
RECEIVED BY ~~